1 in 3 first time mother's need forceps or vaccum

[KayBM]

Just stumbled across leaflet on rcog site...it was published in April 2020, so too late for me! But it says 1 in 3 women who are first time mother's need forceps or vaccum. Pretty sure there should be a bit of discussion about this with midwife...

The leaflet also says that for women who don't want an assisted birth they should consider a caeserean.

Just wondering if any first time mother's out there have been told this? Do you think women should be told this? Anyone think this should be on the NHS site too?

Anyone else think that a natural birth is highly unlikely for a first time mother? I wonder what the induction rates and c section rates are for first time mother's too?

I hypnobirthed, had a private course and practised liked mad. Still had emergency forceps.

I’m all for hypnobirthing and would recommend to anyone but PLEASE do not try to suggest that it will avoid instruments. We need to move away from making women think they ended up with birth injuries because they didn’t make correct decisions or give birth the correct way.

Needing forceps etc is mainly down to luck.

Unnecessary intervention for example, sweeps, induction because the baby has not arrived by the ‘date’ doctors have given you for your baby to arrive. (I am not talking about induction for medical reasons or inductions over 42 weeks) examinations during labour for the sole reason of finding out how dilated you are, even against the wishes of the mother (as in my case). These are just a few

The Swedish study that ended with 6 tragic stillbirths concluded labour should be induced by 41 weeks. Not 42.

As for the sweeps, surely a sweep to bring on labour (if possible) is better than induction?

As for the examinations you can decline them if all is going well.

@KayBM I was induced and so were a handful of other women I know.

Everyone only mentions too strong and too many contractions after you had your induction as no one knows whether it's normal. My pressary was removed after 90 mins and so were two other women I talked to. None of us have birth injuries.

In my case my DP knew that he had to insist on ensuring things were done for me as we were warned by the head antenatal midwife in advance.

This is why I insisted on c sections due to fear of intervention, these stats needs to be more widely known.

@Wolfgirrl where is the conclusive evidence sweeps work?

@FourPlasticRings

You have just added in induced on the spontaneous birth category. That is not what was in your previous post. You also put c section there as well.

How many of those spontaneous are induced? There are a lot of women who are induced who have instruments or EMCS but I am presuming a lot who also have an unassisted vaginal birth...but that doesn't mean it is without intervention. I never saw the statistic for induced in that study you reference.

The study is also 3 years old. Clearly the instrumental rate has gone up to 33% since then according to the RCOG. It says 1 in 3 women having their first baby. Why are you not considering that EMCS and induction has gone up since then?

I'm not saying they have, but I can't say they haven't.

You have just added in induced on the spontaneous birth category. That is not what was in your previous post. You also put c section there as well.

Should have been- I copied and pasted directly from weepingwillow's post and it was definitely there then!

I did add the words this would mean roughly 50% induced/c section compared to 50% starting themselves the second time in case you didn't understand the word spontaneous the first time it was posted.

I do not know anyone personally who has had forceps or suction, I was induced with both my DC and everything was fine until the placenta was delivered!

It should be something spoken about more but I don't think people should just chose to have a c-section because of statistics.

@Szalinski

I did this! Never even glanced at anything to do with hypnobirthing, but I too went into a trance like state, counting my breath and bizarrely I remember staring out of the window 😂😂despite a 36 week drip induction with zero pain relief (not even gas and air) I didnt make a single peep.

I have always said going into birth without expectation or agenda kept me so relaxed that my induction worked when the odds were heavily stacked against me.

That's generally why I am against overloading women with information, detailed birth 'planning' etc

Hi Time, I was repeatedly told all the way through my pregnancy that I should go to the local standalone midwife unit as I was low risk, that I'd be fine etc.

I had reservations about this right the way through, thinking but what if something goes wrong? There aren't any doctors and obviously pain relief was minimal (just gas and air).

Anyway as a first timer, I just didn't have the confidence or energy to argue with them. So my waters broke at home and the contractions came on thick and fast. We duly went to the midwife unit where I was found to be 4cm. I then dilated very quickly, within an hour and a half and then started pushing......they kept me pushing for 90 mins at which point I was told they were now very concerned and I was taken by blue light ambulance to hospital 45 mins away.

I remember them telling me that they were going to try with forceps, I don't recall them asking me but by that point I was just besides myself and wanted the baby out ASAP. The registrar had to fight to get him out and when he was born she declared 'oh he's sunny side up!' (B2B)

I ended up with a lot of internal/external stitches. I couldn't sit down for about 3 months without pain. I developed a vaginal prolapse. The whole thing was just a complete mess really. It took about 12 months to feel anywhere close to normal. The mental scars took a long time to heal.

As I mentioned I'm now trying to conceive my second 6 yrs later. I will be insistent on an ELCS this time. I simply cannot risk that happening again although I'm sure they will try to convince me otherwise.

Sorry that was long.

@BeforeIPutOnMyMakeup

^A total of seven studies consisting of 2252 participants were selected for the review and meta-analysis. The results revealed that membrane sweeping is advantageous in promoting spontaneous labour (RR = 1.205, 95% CI: 1.133-1.282, p =

@FourPlasticRings that's really helpful thank you.

The pressure on the perineum thing is interesting (not sure how that works in a water birth which is what I'm hoping for is all goes well?!). I guess that stage is potentially really quick.. maybe an idea to speak to the midwife about it before getting to that point. And I will definitely make sure my partner knows this stuff.

Thanks again.

@PorridgeStoat

I hope your birth goes well! At least you've got some good info on here 🙂

I personally think it has A LOT to do with your midwife, could be totally wrong but with my DD labour was horrendous my midwife left me the whole time was in agony so had the pain relief injection ended up with a tear and PPH I was traumatised.

Second DC had an amazing student midwife with me the whole time, had the hormone drip and pushed out my 9 LB 9 son 'A whopper' as the midwife said without even a graze and just gas and air. Pushing him out was REALLY hard but they kept my motivation up and I got him out myself!

Surely they only intervene if it's necessary though? I can't imagine them using forceps or a vacuum if the baby is going to be born safely, although someone will probably tell me otherwise

@Szalinski I am so sorry that was so awful for you. Did they say why the baby got stuck and wouldn’t come or why there was a danger?
I have a friend who was in a very similar position to you- awful birth experience and PND. She eventually went for a second child a few years later and managed to convince the consultants (because of PND) that she needed an elective csection. It wasn’t easy but it wasn’t an extremely hard battle either. All went well with the csection.

Wow this thread has got people talking! I'm glad I put across my questions in my post... it's good to see so many contributions.

A question for the more experienced mums/midwives on the thread:

Is it possible to tell in early labour (by which I mean not yet fully dilated) what position the baby is in? Can the midwife feel the bump etc and judge this? Ideally, if my baby is back to back I much prefer my chances with a c section rather than continuing with a vaginal birth that's likely to end up with forceps but is it realistic to be able to make this judgement?

I'm really sorry to hear of all the stories of births which have been traumatic and caused injuries. But I have read that any birth can be traumatic whether it appears straightforward or not.

porridge my understanding is that babies often turn during labour, so it's hard to tell. DS was back-to-back when I went in to be checked because my waters had broken but he was born the right way up (and fairly quickly and relatively easily) 20 hours later

@PorridgeStoat

On another thread, other women said hey had similar labours when they had back to back babies...early waters breaking, wanting to push before fully dilated. So I think there are signs you can pick up on yourself if you know them. But hopefully a midwife can tell you more

@Time - he was back to back unfortunately and got himself wedged. Yes I'm prepared to argue my case for a csection next time. I'm not as meek as I used to be

@wolfgirl - Ha that's funny that you also went into the hypnobirthing trance! I didn't have any pain relief either as I was contorting my mouth into this weird shape and I couldn't suck on the g&a pipe at the same time! However had an epidural been available I would've had it without hesitation!

Wolf- sad about the Swedish study but that does not take away the numbers of women who are given the option of early induction for non essential medical reasons and then end up with further interventions. There have been many studies at lots of first babies do not arrive at the magic 40 week mark. I do agree there have been studies showing that leaving it longer than 42 becomes risker. Sweeps would be better than induction but I know dozens of women who have been offered sweeps way before 40 weeks. There have also been studies showing that interfering with the cervix this way actually hinders rather than helps the cervix prepare for birth. It’s my view that in future generations this will seem an awful way of treating women / ‘starting labour off’ as shaving and enemas as routine seems now.
I also know dozens of women who asked their gp for an induction when they got to 39 weeks because they wanted baby to come. No other reason. Women need to be informed of the risks of further intervention in these cases to make an informed choice.
Please note that I do not blame any woman for having forceps, interventions or anything else. But choices made certainly do lead to varying outcomes. @RoosterPie I am not blaming women for these choices. Better medical advice should be given, far better information, classes and knowledge should be given to pregnant women free of charge. The free classes given by the NHS are woefully inadequate in many cases.
As I said before the fear around childbirth is a huge barrier. This is not easily undone as it’s been instilled over more than 100 years of medicalising births.

The other thing to say is - and I don't mean this to sound discouraging, just realistic - is that it's a lot harder to express this kind of preference in reality than you think it will be, in the experience of me and many of the other women I know. I didn't have a birth plan as such but I did have some things that I thought I would be firm on, and that DH was fully briefed to support me on and also push on. In the event, they simply wouldn't accept I was in labour and I couldn't even get them to examine me even though I was pushing - DS was nearly born in the triage room. When a midwife finally examined me, after telling me yet again that there was no point because I wasn't in active labour and I should just go home, she exclaimed 'I can see the head!'. DS was born 40 minutes later after I was rushed into the labour ward.

I'm saying this not to try and scare you - mine was actually quite a nice labour, in lots of ways! - but because I thought I'd be much more able to express my own preferences and needs than I was, and I'm still not sure, if I went back in time, how I would get them to listen. I thought I'd be much more in control of the process than I was, and I'm not sure how helpful that expectation was.